Solid Tumors, Neoplasms (Cancer / Tumors), Advanced Malignant Solid Neoplasm, Locally Advanced Malignant Solid Neoplasm, Unresectable Malignant Solid Neoplasm, Metastatic Malignant Solid Neoplasm, HER2 Expression, Biliary Tract Neoplasms, Endometrial Neoplasms, Urothelial Carcinoma (UC), Pancreatic Neoplasms, Colorectal Neoplasms, Gastric Neoplasms, Non-Small Cell Lung Carcinoma (NSCLC), Head and Neck Neoplasms, Cervical Neoplasms
Conditions
Keywords
HER2 expression, Trastuzumab Rezetecan, Advanced Solid Tumor
Brief summary
The goal of this clinical trial is to learn if Trastuzumab Rezetecan can treat advanced solid tumors with HER-2 expression in adult participants. The main question it aims to answer is: What is the objective response rate of Trastuzumab Rezetecan in adult patients with HER-2 expressed advanced solid tumors? Participants will receive intravenous infusion of Trastuzumab Rezetecan on Day 1 of each 21-day treatment cycle. The dosage is 4.8 mg/kg per cycle; participants with a body weight of 85 kg or above will receive a fixed dose of 408 mg every 3 weeks.
Interventions
Trastuzumab Rezetecan will be administered on Day 1 of each 21-day cycle as specified. The dose is 4.8 mg/kg (fixed 408 mg for body weight ≥85 kg). Treatment continues until tumor progression or occurrence of unacceptable toxicity.
Sponsors
Haihua Yuan
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
This is a single-arm, exploratory basket study.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Male and female participants aged 18 years or older. 2. Participants with locally advanced, unresectable or metastatic solid tumors who have progressed after at least one prior systemic therapy for advanced/metastatic disease, or have no satisfactory alternative treatment options. Eligible tumor types include but are not limited to biliary tract cancer, endometrial cancer, urothelial carcinoma, pancreatic cancer, colorectal cancer, gastric cancer, non-small cell lung cancer, head and neck adenocarcinoma (salivary gland adenocarcinoma, lacrimal gland adenocarcinoma, adenocarcinoma of unknown primary in the neck), cervical cancer, ovarian cancer and adenocarcinoma of unknown primary. Breast cancer is excluded. 3. Eastern Cooperative Oncology Group Performance Status (ECOG PS) of 0 or 1. 4. Confirmed HER2 expression defined as IHC 1+, 2+ or 3+ (per GC criteria). 5. Willing and able to provide adequate tumor specimens for central pathological re-testing of HER2 status. For participants previously treated with anti-HER2 therapy, tumor specimens obtained after the last anti-HER2 treatment are optional. 6. At least one measurable lesion at baseline per Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1. 7. Adequate organ and bone marrow function within 14 days prior to enrollment, meeting the following criteria: Hemoglobin ≥ 9 g/dL; Platelet count ≥ 100,000/mm³; Absolute neutrophil count (ANC) ≥ 1500/mm³; Serum albumin ≥ 3.0 g/dL; Prothrombin time (PT), activated partial thromboplastin time (aPTT) and International Normalized Ratio (INR) ≤ 1.5 × upper limit of normal (ULN); Aspartate transaminase (AST) and alanine transaminase (ALT) ≤ 3 × ULN; ≤ 5 × ULN for participants with liver metastases; Total bilirubin ≤ 1.5 × ULN for participants without liver metastases; ≤ 3 × ULN for participants with Gilbert's syndrome or liver metastases at baseline; Creatinine clearance ≥ 30 mL/min (calculated by the Cockcroft-Gault formula) 8. Left ventricular ejection fraction (LVEF) ≥ 50% assessed by echocardiogram (ECHO) or multigated acquisition (MUGA) scan within 28 days prior to enrollment.
Exclusion criteria
Participants meeting any of the following conditions are ineligible for this study: 1. Presence of any severe and/or uncontrolled diseases: * Poorly controlled blood pressure (systolic blood pressure ≥ 150 mmHg or diastolic blood pressure ≥ 100 mmHg); poorly controlled diabetes (fasting blood glucose \[FBG\] \> 10 mmol/L). * Grade ≥ 2 myocardial ischemia, myocardial infarction, arrhythmia (QTc interval ≥ 470 ms), or Grade ≥ 2 congestive heart failure (per New York Heart Association \[NYHA\] classification). * Active or uncontrolled severe infections (Grade ≥ 2 per NCI CTCAE) requiring systemic antibacterial, antifungal or antiviral therapy, including pulmonary tuberculosis. * History of active tuberculosis. * Uncontrolled ascites, pericardial effusion or pleural effusion requiring repeated drainage. 2. Active hepatitis: Liver function not meeting the inclusion criteria. Hepatitis B: HBV DNA ≥ 2000 IU/mL or ≥ 10\^4 copies/mL.Hepatitis C: HCV RNA ≥ 2000 IU/mL or ≥ 10\^4 copies/mL. Participants with viral load below the above thresholds after nucleoside antiviral therapy are eligible. Chronic hepatitis B virus carriers with HBV DNA \< 10\^4 IU/mL must receive concurrent antiviral treatment throughout the study for enrollment. 3. History of immunodeficiency diseases, including HIV positivity or other acquired/congenital immunodeficiency disorders. 4. History of allogeneic solid organ transplantation or allogeneic hematopoietic stem cell transplantation. 5. Confirmed meningeal metastasis, spinal cord metastasis or spinal cord compression. 6. Within 6 months prior to the first study drug administration, presence of esophageal gastric varices, severe ulcers, unhealed wounds, gastrointestinal perforation, abdominal fistula, gastrointestinal obstruction, intra-abdominal abscess, acute gastrointestinal bleeding, extensive intestinal resection (partial colectomy or extensive small bowel resection complicated with chronic diarrhea), Crohn's disease, ulcerative colitis or long-standing chronic diarrhea. 7. Unhealed or poorly healing wounds, or active ulcers. 8. Toxicities from prior anti-tumor therapy have not resolved to Grade 0 or 1 per NCI CTCAE version 5.0. 9. Received major surgery, incisional biopsy or significant traumatic injury within 28 days before study treatment initiation; or with long-standing unhealed wounds or fractures. 10. History of severe hypersensitivity reactions to monoclonal antibodies; known allergy to the active ingredients or excipients of the study drug.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Objective Response Rate, ORR | From the date of first study treatment until disease progression or death from any cause, whichever occurs first, assessed up to 24months. | The Objective Response Rate (ORR) is defined as the percentage of patients whose best response on or before the first occurrence of disease progression is a complete response (CR) or partial response (PR). Tumor responses were assessed by investigators using Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Duration of Response, DOR | From the date of first documented response (complete response [CR] or partial response [PR]) to the time of disease progression or death from any cause, whichever occurs first, assessed up to 24months. | Duration of Response (DoR) is defined as the time from the date of first documented response (CR or PR) to date of first occurrence of disease progression as determined by the investigator, or death from any cause, whichever occurs first. |
| Progression-Free Survival, PFS | Through study completion, an average of 2 years. | Progression-Free Survival (PFS) is defined as the time from the start of study treatment to the first occurrence of disease progression, or death, whichever occurs first. Tumor responses were assessed by investigators using RECIST version 1.1. |
| Overall Survival, OS | Through study completion, an average of 2 years. | Overall Survival (OS) is defined as the time from the date of the first study treatment (Day 1) to the date of death from any cause. |
| Disease Control Rate, DCR | From the date of first study treatment until disease progression or death from any cause, whichever occurs first, assessed up to 24 months. | Disease Control Rate (DCR) is defined as the proportion of patients whose best response is CR, PR or SD maintained more than 8 weeks. Tumor responses were assessed by investigators using RECIST version 1.1. |
| Best Overall Response, BOR | Through study completion, average follow-up of 2 years. | Best overall response (BOR) is defined as the best tumor response achieved at any time during treatment, categorized as Complete Response (CR), Partial Response (PR), Stable Disease (SD), or Progressive Disease (PD) per RECIST 1.1 criteria. |
| Time to Response, TTR | Through study completion. | Time to response (TTR) is defined as the time from the date of first study drug administration to the date of first documented and confirmed CR or PR per RECIST 1.1. |
| Patient-reported outcomes, PROs | Baseline and every 12 weeks during treatment. | Patient-reported quality of life changes measured by the EORTC QLQ-C30 questionnaire. Questionnaires are completed at baseline and repeated every 12 weeks during treatment to evaluate changes in patients' quality of life over time. |
| Adverse Events, AEs | From first study drug administration through 40 days after the last dose; overall average follow-up duration is 2 years. | Incidence, severity (graded per NCI CTCAE version 5.0), and causality of adverse events (AEs). |
Contacts
CONTACTHaihua Yuan
Outcome results
None listed